GP won't accept private test results. Why? - Thyroid UK

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GP won't accept private test results. Why?

Tginger
Tginger

Hi! I received my results from Medichecks today with notes saying my TSH is high and FT4 is low which suggests my levo dose needs increasing. I then spoke to a GP on the phone and she said they are not allowed to accept private test results. She also said she could request a repeated test on NHS for me but even if the results are the same as from Medichecks she won't increase my dose as results are within range/almost within range. My results are:

TSH 3.76 [0.27 - 4.20]

FT4 11.90 [12.00 - 22.00]

FT3 4.68 [3.10-6.80]

Thyroglobulin ab 32.400 [0.00 - 115.00]

Thyroid peroxidase ab 509 [0.00 - 34.00]

I'm on 75 mcg levothyroxine.

Having read many posts here I can see that my results are not normal and I'm undermedicated and I'm not feeling well.

Is this true that NHS doctors are not allowed to accept private test results? Why is that?

Thank you.

31 Replies
oldestnewest

No it is definitely not true. For instance, my NHS Endo recently recommended increasing my T3 on the basis of my private Thriva results, and wrote to my NHS GP saying so!

As the NHS are currently under pressure financially - you may wish to point out to your very arrogant GP that you are saving them money in order to have the full testing done and to find wellness.

Are you and your GP aware you have Hashimotos ?

Your FT4 is below range so something is very wrong - how do you take your Thyroid Meds ?

Tginger
Tginger in reply to Marz

Ha-ha, this what I actually thought -- I saved NHS money by paying for the private test and they are not happy, a bit silly isn't it?

I'm aware I've got Hashimoto's but none of the GPs I've been to (6x actually) understand it. When I had my very first thyroid test in 2014, my ATPO were >1300 and the doctor said that I didn't have any problems with my thyroid at all.

I take levo first time in the morning with water as I wake up, 60 minutes before breakfast. No milk or calcium rich products within 4 hours.

Marz
Marz in reply to Tginger

Such a shame there is so little understanding ... I was diagnosed with Hashimotos here in Crete back in 2005. Raised Anti-bodies - well over range - in range Thyroid results. My GP at the time prescribed Levo as she felt my thyroid needed support whilst under attack :-) Then my journey of reading and learning began !

Can you speak to another GP at your practice about this? You do need a dose increase, but it sounds like the only way to get one is from a different GP...

Tginger
Tginger in reply to Cooper27

Not sure if any GPs I haven't seen yet left in my surgery. Next step -- changing to a different surgery? :)

In your post/thread of 3 months ago - it was mentioned you needed tests/results for B12 - Folate - Ferritin and VitD - did you manage to have these tests ?

healthunlocked.com/thyroidu...

Tginger
Tginger in reply to Marz

Thank you for mentioning this. Yes, I've had all the tests and now supplementing Vit D.

Marz
Marz in reply to Tginger

So what was your result - and how much D are you taking ? GP's often prescribe too little. How was the B12 - Folate and Ferritin ?

Tginger
Tginger in reply to Marz

Vit D 54.8 [50.00 - 150.00]

B12 68.30 [37.50 - 188.00]

Folate 13.33 [3.89 - 26.80]

Ferritin 91 [13.00 - 150.00]

The GP insisted that I didn't need supplementing. I still decided to give a try to Vit D 3000ui/ day and now thinking to start B12 as well.

Marz
Marz in reply to Tginger

OK your dose of Vit D could well improve levels - a result of100++ is suggested as being good. Also Magnesium and VitK2-MK7 needed as important co-factors. Lots of information here on the forum.

Your B12 is the Active B12 Test and I have read that around 70 is good - so you are almost there. A good B complex would give you a maintenance dose of B12 and all the other B's to keep them all in balance ..

Tginger
Tginger in reply to Marz

Thank you Marz, Magnesium and VitK were actually next on my list.

You could refer your GP to the BMA guidance given to him thus:

Can patients receive part of their treatment within the NHS and part privately?

Dilemmas can arise if patients choose to seek part of their treatment privately and part on the NHS.

A common scenario is where a patient pays for private investigations in order to obtain an earlier diagnosis and then switches back to the NHS for any subsequent treatment.

Patients who seek private investigations:

• may opt into or out of NHS care at any stage, provided they are entitled to NHS treatment

• may subsequently be placed directly onto the NHS waiting list at the same position as if those investigations had been undertaken within the NHS (where the treatment in question is not provided by the NHS but is clinically necessary, see Top up payments below)

• do not need to have a further assessment within the NHS before receiving their treatment, nor do

they need to be referred back to their general practitioner (GP).

Tginger
Tginger in reply to MaisieGray

Thank you for this information

Good work this advice is fantastic

Can you post a link?

bma.org.uk/-/media/files/pd...

is the link. It is very good advice.

No it is not true that NHS doctors are not allowed to accept private test results. if the lab is accredited by the United Kingdom Accreditation Service for the tests carries out, that is good evidence and just as good as any NHS lab.

The General Medical Council's Code of Practice - Good Medical Practice, states at paragraph 16b that doctors MUST "provide effective treatments based on the best available evidence". I think that test results from any laboratory that is accredited by UKAS is good evidence.

i personally would stand my ground, inform him/her of the UKAS accreditation and advise him /her that s/he is not bound to NHS test results and s/he should act on the results.

Sometimes I lose courage when speaking to doctors even if I come to an appointment well prepared. I'll copy your message for my next appointment :) Thank you.

Hidden
Hidden in reply to Tginger

I'm the same Tginger. And some just won't listen whatever you say. There's also the problem of not being able to think straight if you are hypo. I always write things down for that reason alone.

Do as Aurealis says and make a list of your worst symptoms and how they affect your life (one sheet of paper if possible, as a busy or impatient doctor won't want to read reams), and ask for help. When I did that, (once with the nurse and once with one of the practice pharmacists - who is brilliant). They scanned it onto my notes and gave me a Levo increase.

Tginger
Tginger in reply to Hidden

Hi Jnetti. Frankly speaking I've done this before and what GPs usually do is they nod as I speak about my symptoms and then request a blood test for me. But when they see that the TSH is within the range they do nothing. I've been through this so many times I'm losing hope now. Maybe when I do it for the 15th-20th time this will break that wall.

Hidden
Hidden in reply to Tginger

Here's what I gave the nurse (we hardly ever seem to be given a face to face appointment with a doctor). Of course you may still be ignored, but if any of it helps you are welcome to use it as a pattern. If you have family hypothyroid symptoms are even more restrictive to your life:

[Name and date]

Dear Doctor

• I still have hypothyroid symptoms

• They affect my quality of life quite a lot

• Everyone is different, and it seems that my TSH levels, though now within range, are not yet optimal for me

Main Symptoms – (worse in the last 3-4 weeks)

1. Frequent or constant:

• Lethargy and difficulty concentrating

• Difficulty in expressing myself in words and remembering what I was saying

• Sense of slight pressure on upper part of breastbone

• Hoarseness or “Tight” feeling in throat. Swallowing is OK but takes more effort. Unable to sing!

• Fine motor coordination is affected

2. Infrequent:

• Episodes of breathlessness (not severe, but breathing is hard work for a few minutes)

• Sometimes (especially when concentrating hard) eyelids swell and the whole of my neck and scalp feel stiff. Scalp tingles

Effect on quality of life:

• All tasks take longer and I run out of energy quickly

• Less ability to concentrate affects short term memory. I may have to stop to think what I was going to do, what things are needed for the task and where to find them.

• Lack of motivation. Deciding to do something and starting to do it takes a lot more mental effort than normal. For example, if someone asks me to do something or I have to be somewhere at a certain time it is much easier because the decision is made for me.

• Ability to drive is restricted. I may have to give it up if thyroid problems continue.

• Typing is difficult and takes a long time because of slowness, frequently hitting the wrong keys and have difficulty concentrating.

*********************************************

Whether you use this or not, DO NOT GIVE UP

If all else fails complain to the Practice Manager, by letter if you find that easier, as I do. All the best xxx

Tginger
Tginger in reply to Hidden

Thank you for your support Jnetti! I just keep giving them the last chance and then another last chance and then another one. I feel I will write to the Practice Manager eventually.

Hidden
Hidden in reply to Tginger

Do it now! Pm me if you need help with composing. I had help with my one and only (so far) letter, though it wasn't on the same issue

Hidden
Hidden in reply to Tginger

I almost typed "composting" instead of composing, lol, but it's too cold and wet for gardening!

Tginger
Tginger in reply to Hidden

:-)

Doctors are just like the rest of us

Good ones and bad ones

It’s my experience that most of the GPS I’ve met are very arrogant and so are the Endos.

The important thing is to be confident and prepared

Remain calm and be sure that you are right to fight for your health and well-being

The approach favoured by patients is logical the GPs isn’t

Ultimately we will get our health but we gave to fight for it

It’s hard when our conditions rob us of energy

That is why these forums are so valuable

Also, the NHS says:

You shouldn't need to have any of the same tests twice – for example, to diagnose or monitor your condition. nhs.uk/common-health-questi...

and

NHS Guidance on NHS patients who wish to pay for additional private care gov.uk/government/uploads/s... says

The Department of Health should make clear that no patients should lose their entitlement to NHS care they would have otherwise received, simply because they opt to purchase additional care for their condition;

Don’t go head to head with her on this, she’s wrong but won’t thank you for pointing this out.

Perhaps revisit your gp with your list of symptoms. What is she going to do about them? Her job is to get you feeling well! Don’t mention thyroid, and don’t accept antidepressants, (that’s their go -to treatment for everything!) She may decide that an increase in thyroid dose may be worth trying instead of treating each individual symptom. How clever of her to think of that. Act amazed !!! (Gosh they wear you out with their stupid games)

Good morning everyone! Many thanks for your advice and support!!!

MaisieGray Marz Cooper27 holyshedballs Aurealis

Hidden
Hidden

Your doctor doesn't seem to know the difference between "Can't" and "Won't".

Don't they want to save money on tests???

Ask him why he's not allowed, or find another doctor (Maybe in the same practice?), practice nurse or practice pharmacist ( I found a brilliant pharmacist in ours) who will listen to reason

Tginger
Tginger in reply to Hidden

I will definitely ask that question :) I wonder what the response will be.

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